Ascites characterizes perioperative clinical indices better than preoperative body mass index. A study in orthotopic liver transplant candidates

Youri L. Vater, G. Dembo, K. Martay, A. Vitin, E. Amar, A. A. Weinbroum

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background. Preoperative body mass index (pre-BMI) affecting patients' recovery from orthotropic liver transplantation (OLT) is controversial. Pre-BMI measurements may be exaggerated by ascites. Aim of the study was the assessment of early outcome associated with pre-BMI and ascites. Methods. Postoperative BMI values and ascites volumes of 206 patients undergoing OLT (2006-2007) were reviewed. Results. There were 141 preoperatively "non-obese" patients (pre-BMI ≤30 kg/m2) and 65 "obese" patients (pre-BMI >30 kg/m2). Demographics and model for end-stage liver disease scores were similar for both groups. Te mean volume of ascites removed from the "non-obese" patients was significantly larger compared to the "obese" ones (P=0.018). Seventeen "obese" patients became "non-obese" postoperatively. Te duration of anesthesia, ischemia, surgery, hemodynamic parameters, estimated blood loss and transfused products were similar for both groups. Ascites volumes correlated significantly (P<0.05) with various intraoperative indices but not pre-BMI. At 24 h postoperatively, the extubation rate was better for the "obese" group (99%) versus the "non-obese" group (93%, P=0.03). However, "non-obese" patients were extubated earlier than the "obese" both by 6 h (45% versus 22%, respectively, P<0.01) and by 12 h (88% versus 74%, respectively, P=0.012). Te postoperative, but not the preoperative BMI, correlated with extubation rate ≤6 h (r=0.924, P=0.0001). No "obese" patients died <1 month postoperatively, compared to 9 "non-obese" patients (P<0.01). Intensive Care Unit and hospital stay were ~25% longer for the "obese" group. Conclusion. Pre-OLT BMI does not correlate with ascites or postoperative BMI, nor does it afect duration of ventilation, especially <6 h after surgery. These results dissociate ascites from pre- and post-OLT.

Original languageEnglish (US)
Pages (from-to)910-919
Number of pages10
JournalMinerva anestesiologica
Volume78
Issue number8
StatePublished - Aug 1 2012

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Ascites
Body Mass Index
Transplants
Liver
Liver Transplantation
End Stage Liver Disease
Intensive Care Units
Ventilation
Length of Stay
Ischemia
Anesthesia
Hemodynamics
Demography
Outcome Assessment (Health Care)

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

Cite this

Vater, Youri L. ; Dembo, G. ; Martay, K. ; Vitin, A. ; Amar, E. ; Weinbroum, A. A. / Ascites characterizes perioperative clinical indices better than preoperative body mass index. A study in orthotopic liver transplant candidates. In: Minerva anestesiologica. 2012 ; Vol. 78, No. 8. pp. 910-919.
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abstract = "Background. Preoperative body mass index (pre-BMI) affecting patients' recovery from orthotropic liver transplantation (OLT) is controversial. Pre-BMI measurements may be exaggerated by ascites. Aim of the study was the assessment of early outcome associated with pre-BMI and ascites. Methods. Postoperative BMI values and ascites volumes of 206 patients undergoing OLT (2006-2007) were reviewed. Results. There were 141 preoperatively {"}non-obese{"} patients (pre-BMI ≤30 kg/m2) and 65 {"}obese{"} patients (pre-BMI >30 kg/m2). Demographics and model for end-stage liver disease scores were similar for both groups. Te mean volume of ascites removed from the {"}non-obese{"} patients was significantly larger compared to the {"}obese{"} ones (P=0.018). Seventeen {"}obese{"} patients became {"}non-obese{"} postoperatively. Te duration of anesthesia, ischemia, surgery, hemodynamic parameters, estimated blood loss and transfused products were similar for both groups. Ascites volumes correlated significantly (P<0.05) with various intraoperative indices but not pre-BMI. At 24 h postoperatively, the extubation rate was better for the {"}obese{"} group (99{\%}) versus the {"}non-obese{"} group (93{\%}, P=0.03). However, {"}non-obese{"} patients were extubated earlier than the {"}obese{"} both by 6 h (45{\%} versus 22{\%}, respectively, P<0.01) and by 12 h (88{\%} versus 74{\%}, respectively, P=0.012). Te postoperative, but not the preoperative BMI, correlated with extubation rate ≤6 h (r=0.924, P=0.0001). No {"}obese{"} patients died <1 month postoperatively, compared to 9 {"}non-obese{"} patients (P<0.01). Intensive Care Unit and hospital stay were ~25{\%} longer for the {"}obese{"} group. Conclusion. Pre-OLT BMI does not correlate with ascites or postoperative BMI, nor does it afect duration of ventilation, especially <6 h after surgery. These results dissociate ascites from pre- and post-OLT.",
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Ascites characterizes perioperative clinical indices better than preoperative body mass index. A study in orthotopic liver transplant candidates. / Vater, Youri L.; Dembo, G.; Martay, K.; Vitin, A.; Amar, E.; Weinbroum, A. A.

In: Minerva anestesiologica, Vol. 78, No. 8, 01.08.2012, p. 910-919.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Ascites characterizes perioperative clinical indices better than preoperative body mass index. A study in orthotopic liver transplant candidates

AU - Vater, Youri L.

AU - Dembo, G.

AU - Martay, K.

AU - Vitin, A.

AU - Amar, E.

AU - Weinbroum, A. A.

PY - 2012/8/1

Y1 - 2012/8/1

N2 - Background. Preoperative body mass index (pre-BMI) affecting patients' recovery from orthotropic liver transplantation (OLT) is controversial. Pre-BMI measurements may be exaggerated by ascites. Aim of the study was the assessment of early outcome associated with pre-BMI and ascites. Methods. Postoperative BMI values and ascites volumes of 206 patients undergoing OLT (2006-2007) were reviewed. Results. There were 141 preoperatively "non-obese" patients (pre-BMI ≤30 kg/m2) and 65 "obese" patients (pre-BMI >30 kg/m2). Demographics and model for end-stage liver disease scores were similar for both groups. Te mean volume of ascites removed from the "non-obese" patients was significantly larger compared to the "obese" ones (P=0.018). Seventeen "obese" patients became "non-obese" postoperatively. Te duration of anesthesia, ischemia, surgery, hemodynamic parameters, estimated blood loss and transfused products were similar for both groups. Ascites volumes correlated significantly (P<0.05) with various intraoperative indices but not pre-BMI. At 24 h postoperatively, the extubation rate was better for the "obese" group (99%) versus the "non-obese" group (93%, P=0.03). However, "non-obese" patients were extubated earlier than the "obese" both by 6 h (45% versus 22%, respectively, P<0.01) and by 12 h (88% versus 74%, respectively, P=0.012). Te postoperative, but not the preoperative BMI, correlated with extubation rate ≤6 h (r=0.924, P=0.0001). No "obese" patients died <1 month postoperatively, compared to 9 "non-obese" patients (P<0.01). Intensive Care Unit and hospital stay were ~25% longer for the "obese" group. Conclusion. Pre-OLT BMI does not correlate with ascites or postoperative BMI, nor does it afect duration of ventilation, especially <6 h after surgery. These results dissociate ascites from pre- and post-OLT.

AB - Background. Preoperative body mass index (pre-BMI) affecting patients' recovery from orthotropic liver transplantation (OLT) is controversial. Pre-BMI measurements may be exaggerated by ascites. Aim of the study was the assessment of early outcome associated with pre-BMI and ascites. Methods. Postoperative BMI values and ascites volumes of 206 patients undergoing OLT (2006-2007) were reviewed. Results. There were 141 preoperatively "non-obese" patients (pre-BMI ≤30 kg/m2) and 65 "obese" patients (pre-BMI >30 kg/m2). Demographics and model for end-stage liver disease scores were similar for both groups. Te mean volume of ascites removed from the "non-obese" patients was significantly larger compared to the "obese" ones (P=0.018). Seventeen "obese" patients became "non-obese" postoperatively. Te duration of anesthesia, ischemia, surgery, hemodynamic parameters, estimated blood loss and transfused products were similar for both groups. Ascites volumes correlated significantly (P<0.05) with various intraoperative indices but not pre-BMI. At 24 h postoperatively, the extubation rate was better for the "obese" group (99%) versus the "non-obese" group (93%, P=0.03). However, "non-obese" patients were extubated earlier than the "obese" both by 6 h (45% versus 22%, respectively, P<0.01) and by 12 h (88% versus 74%, respectively, P=0.012). Te postoperative, but not the preoperative BMI, correlated with extubation rate ≤6 h (r=0.924, P=0.0001). No "obese" patients died <1 month postoperatively, compared to 9 "non-obese" patients (P<0.01). Intensive Care Unit and hospital stay were ~25% longer for the "obese" group. Conclusion. Pre-OLT BMI does not correlate with ascites or postoperative BMI, nor does it afect duration of ventilation, especially <6 h after surgery. These results dissociate ascites from pre- and post-OLT.

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